HomeMy WebLinkAbout23-5965City of Zephyrhilis
535 Eighth Street
ttti 1, ti
ephyrhllls, FL 33542
Phone: (313) 730-0020
Fax. (813) 730-0021
Issue lasts. 0411112023
Pe
C 1'Residential
1
; ,. ..,. ..
i
04 26 21 0150 00900 0020 36508 Smithfield Lane
a
Name: LENNAr NAMES LLC-OWNER Permit Type: Building New (residential) Contractor- L NNAR HOMES LLC
Class of Work: SFr Construct
Address: 4600 W Cypress St 200 wilding Valuation: $320,640.00
TAMPA, FL 33607 Electrical Valuation: $48,096.00
Phone: (813) 574-5700 Mechanical Valuation: $22,444.80 �e
Plumbing Valuation: $32,064.00
Total Valuation: $423,244.80
Total Fees: $20,754.25 A ( ?�
Amount Paid: $20,754,25 -
,,Date Paid: 4/1112023 3:28:11 PM
CONSTRUCT SINGLE FAMILY 2217 SQ FT
Water Connection residential Fee $1,140.00 SIF 1 percent Fee $83.28
Mechanical Permit Fee $152.22 Driveway Fee $45.00
Public Safety Impact Fee -Police $254.00 Electrical Permit Fee $280A8
Building Plan Review Fee $180.00 Address Fee $30.00
Transportation Impact Fee - City $36,32 Transportation Impact Fee $3,595.68
Mechanical Plan review Fee $0,00 Park Impact Fee - Single FamilylTownhome $769.56
Irrigation 314 Meter (Calc) $794.92 School Impact Fee - Single Family $8,328.00
Sewer Connection residential Fee $2,400.00 Electrical Flan Review Fee $0.00
Plumbing Permit Fee $200,32 314 Water Meter Fee (Calc) $794.92
Building Permit Fee $1,643.20 Plumbing Flan review Fee $0.00
Public Safety Impact Fee -Admin $26.35
REINSPECTION FEES: () With respect to Reinspection fees will comply with Florida Statute 553.80(2)(c) the
local government shall impose a fee of four tires the amount of the fee imposed for the initial inspection or
first reinspection, whichever is greater, for each subsequent reinspection.
Notice: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permit required from other governmental
entities such as water management, state agencies or federal agencies.
"Warning to owner: Your failure to record a notice of commencement may result In your paying twice for
improvements to your property. If you intend to obtain financing, consult with your leader or are attorney
before recording your notice of commencement."
Complete Plans, Specifications add fey Must Accompany Application. All work shall be performed in
accordancewith City Codes and Ordinances, NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
kAI
CONTRACTOR SIGNATURE
2
t
PE IT oFFICE
THOUT APPROVED INSPECTION
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received Phone Contact for Permitting�Phone
770 _ 7763 1)
r-e-
Owner's Name CAL HEARTHSTONE LOT OPTION POOL 03 L P Ownermber 813.574.5700
23975 Park Sorrento, Ste. 220, Calabasas, CR 91302
Owner's Address Owner Phone Number
Fee Simple Titleholder Name I N/A Owner Phone Number
Fee Simple Titleholder Address N/A
JOB ADDRESS 36508 S11 mithfield Lane LOT# 0902
SUBDIVISION Abbott Square � PARCEL to# 04-26-21-0150-00900-0020
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR ADDIALT SIGN DEMOLISH
INSTALL REPAIR
PROPOSED USE SFR COMM OTHER
TYPE OF CONSTRUCTION BLOCK FRAME STEEL
DESCRIPTION OF WORK Single Family Residence /Pool /Screen Enclosure !Fence
BUILDING SIZE U/R SF 2672 SO FOOTAGE 2217 HEIGHT 28`
BUILDING VALUATION OF TOTAL CONSTRUCTION
ELECTRICAL $ 48096 PROGRESS ENERGY W.R. E.C.
AMP SERVICE
PLUMBING $ 32064 " w r�
� t
MECHANICAL $ 22444.$ VALUATION OF MECHANICAL INSTALLATION "
=GAS ROOFING SPECIALTY = OTHERr --- S r�
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA Li YES I o
BUILDER o COMPANY Lermar Ilomes, LLC
SIGNATURE REGISTERED Y / N_j FEE CURREN Y / N�"
Address License #
430 7 Boy Scout Blvd Suite 600 Tampa, FL 33607 CGC151816-6
.._.��..��
ELECTRICIAN COMPANY EdmonSOn Electric Inc.
SIGNATURE 8 REGISTERED Y / N � FEE CURREN
Address License# I EC13005408
PLUMBER.__. COMPANY Sayonet Plumbing, HeatingAC,
SIGNATURE REGISTERED
YCRRAddress License # GFG042998�^ -�
MECHANICAL T COMPANY �ayonet �Plumbin�g,Heat�ing&C, Inc
SIGNATURE REGISTERED Y / N�
Address License # GAG058062
OTHER COMPANY C Sterling Quality Roofing, Inc
SIGNATURE REGISTERED YIN FEE CURREN Y { N
Address I e ^� License # I CCCO57991 �
IIIIiIllll//1111/1111/1/tlllt///11111/111/IIIItl1111Ftl1/1/1111/11/11
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms, R-O-W Permit for new construction,
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster, Site Work Permit for subdivisions/large projects
COMMERCIAL Attach (2) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W Permit for new construction.
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance
SIGN PERMIT Attach (2) sets of Engineered Plans.
****PROPERTY SURVEY required for all NEW construction.
Directions:
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement is required. (A/C upgrades over $7500)
Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (copy of contract required)
Reroofs if shingles Sewers Service Upgrades A/C Fences (PioUSurvey/Footage)
Driveways -Not over Counter if on public roadways..needs ROW
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
contractors to undertake work, they may be required to be licensed in accordance with state and local regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
intended work, they are advised to contact the Pasco County Building Inspection Division —Licensing Section at 727-847-
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the
contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of
use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or
final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I
certify that 1, the applicant, have been provided with a copy of the "Florida Construction Lien Law —Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the "owner", I certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the "owner" prior to commencement.
CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work
will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is
hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has
commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is
my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to:
Department of Environmental Protection -Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment.
Southwest Florida Water Management District -Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
Army Corps of Engineers -Seawalls, Docks, Navigable Waterways.
Department of Health & Rehabilitative Services/Environmental Health Unit -Wells, Wastewater Treatment,
Septic Tanks.
US Environmental Protection Agency -Asbestos abatement.
Federal Aviation Authority -Runways.
I understand that the following restrictions apply to the use of fill:
Use of fill is not allowed in Flood Zone W" unless expressly permitted.
If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
"compensating volume" will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida.
If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
construction, I certify that fill will be used only to fill the area within the stem wall.
If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots less than one (1)
acre which are elevated by fill, an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension
may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned.
IMMA 101MRIVAJ
OWNER OR AGENT
Subscribed and sworn (or affirmed) before me this
3/21,'2023 by Christopher Smith
Who is/are personally known to me or4;a&A4a*e-pfo46Ged.
as identification,
Public
Commission �•���__Notary
Stephanie Farmer
Name of Notary typed, printed or stamped
13,1SUM, HOUIF"
� A —
Subscribed and sworn to (or affirmed) before me this
—,by Christopher Srmth ----
or has/have produced
as identification.
�..Notary Public
Commission No. 6 7
Stephanie Farmer
Name of Notary typed, printed or stamped
"R-1- WSUMMMLERAN
s 0 N",
Permit No, /
DatePermitted �'� � �`
Builder Name/Owner Nape C'L. Control
County Parcel No. f f ` Ci SubDiv: l e T �
Address/Location
Classification/Type of flee V � d
TRANSPORTATION IMPACT FEE � Rate: _ _ Sq. Ft unit: s
Exempt Yes D No How Determined
Impact Fee Amount j_30 - Zone No. TAZ:
SCHOOL IMPACT FEE
Account (056)
Single -Family Detached blouse Amount
(057)
Mobile Home
(058)
Other Residential
(123)
Collection Fee
Exempt =Yes
= No Flow Determined_
PARKS AND RECREATION FEE
Land Account Land Credit land Total
Recreation Account Recreation Credit Recreation Total
Zone Total Amount
Exempt =Yes = No How Determined
Land Account Land Credit Land Total
Facility Account Facility Credit Facility Total
Exempt =Yes No How Determined Total Amount''
RESOURCE FEE ERU
Total Amount
Prepared By _� Checked By
CERTIFICATE CIF OCCUPANY WILL E ISSUED OR FINAL INSPECTION
PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE
BEEN PAID AND RECEIPTED FOR BY A CENTRAL PERMITTING G OFFICE OF PASCO COUNTY
ACKNOWLEDGEMENT BELOW DOES NOT IMPLY ACCEPTANCE OF CONCURRENCE„ BUT SIMPLY REECEIPT OF A COPY OF THIS
FORM, PLACING THE BUILDING OWNER ON NOTICE OF THIS ASSESSMENT AND THE CONDITIONS OF PAYMENT FOR SAME,
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DESCRIPTION: LOT 2, BLOCK 9, ABBOTT SQUARE PHASE IB,
I
SITE PLAN
.SEC. 4, TWP. 26 S, RNG 21 E.
ACCORDING TO THE PLAT THEREOF, RECORDED IN PLAT BOOK 89.
PASCO COUNTY, FLORIDA
PAGES 57-62, OF THE PUBLIC RECORDS OF PASCO COUNTY,
FLORIDA.
)NOT A SURVEY)
(ABBOTT SQUARE)
PROPOSED ELEVATIONS AND GRADING his 517E
LAN Prepared for and
Certrf,ed 7o ALL ELEVATIONS REFERENCED
SHOWN HEREON ARE TAKEN FORM THE jj
Lenna. Homes
TO NORTH AMERICAN
1 ENGINEERING PLANS OF 1 '•'"•'••'•
'-- •• """ ' •"'°"•'--
VERTICAL DATUM OF 1988
'ABBOTT SQUARE RESIDENTIAL', PREPARED
,NAND SSI
BY °WRA" PROVIDED BY CLIENT
i
Scale.- 1 ' = 20'
TRACT"A"
CUD) RIGHT-OF-WAY
S ITHFIELD LANE
—^ T
N89-45.37-E!P)
BASIS OF BEARING
' z2 0'
N 89'45'31' E (Pj 45.00' (P) 1• 5CONC WALK'
3' sX
..._... _ .....-
CONC _
LOT = 562a SCT FT -
LIVING AREA =�_,1 SCL FT.
;o _ WRLI<
PORCH =_ SO, FT
GARAGE = 4QL--SQ. FT.
T5' °: 16.0'
•....:.20.0
COVERED LANAI FT
PATIO = 1_SQ. FT.
w
POOL AREA = NA__SQ. FT.
ENTRY 10.0'
CONIC. DRIVE =�$_-SQ. FT.
A/C & CONC PAD = i 2 _SO. FT.
PROPOSED
SIDEWALK =(,- —SO. FT.
2 STORY RESIDENCE
LOT SOD = N7A SQ. FT.
PLAN 2Z 16 a
R/W SOD =�1/A SO. FT.
c LOT 3
o ELEV "A" A c
LOT OCCUPIED =.�%
LOT] a
-
a
GARAGE R w 4 BLOCK 9
AREA TO IRRIGATE o
=�T /n
BLOCK 9
ti
�
¢ �
N
30-0,
a
kTS 3(W 7,5 o
.9
* = 10.00 PUBLIC UTILITY EASEMENT
0 X6
3.X60
PATIO
C/S-A/C
LEGEND:
78�
_i -'-�^•= PROPOSED DRAINAGE FLOW
,iQp
LOT Z
X
(00.00) _ PROPOSED GRADE
BLOCK 9
i
E-00.00 = EXISTING GRADE
c I 1
NOTES:
LOT GRADING TYPE = B
PROPOSED PAD ELEVATION = 102-10
L
FRONT SET BACK = 20'
SIDE SET BACK = 7C
1
SIDE SET BACK (CORNER LOT) =10
REAR SETBACK=- 15'
----------
ISPI
S 89'45'24° W (P) 45.00' IP) "/v07�0
TRACT ' B-6" /
PROPOSED:
(CUD) ACCESSfDRAINAGE,
MINIMUM FLOOR ELEVATIONS:
LANDSCAPE/ WALL
LIVING AREA: 102.77'
MAINTENANCE AND FENCE AREA,
GARAGE AREA:
oPENSPaCE
ELEVATIONS REFERENCED TO
NORTH AMERICAN VERTICAL
DATUM OF 1988
APPARENT FLOOD
(MAP NUMBER 12101C-0285
HAZARD ZONE: "X" COMMUNITY NO.
F) EFFECTIVE DATE: 09/26/2014
120235
SURVEY ABBREVATIONS
A),ARCI NCTH
(D)=NEED
WV - INVERT
PC=PORN OE CURVE
iRj-RECORD
LEGEND
A/C =AIRCONDt ONER
DF= DRANACE EASEMENT
IB-LICLNSEDBUISNCSS
PCC PONT OF COMPOUND CURVE
RNG=RANG:
VINY �FNCE
A , ALUM N JM t FNfE
EL OR ELE V ELEVATION
t E - LANDSCAPE l ASEMI"W
PCP ! RMANERE CONTROL POINT
RR ROAD SPIKE
-GONG f^1�
Rt=6AS, LOODDEVATON
'AVEMEN
O =EEAS
i. E=LOWS VAT.Ch
l00-:QtI EQUIPMENT
-Rf
=RG OF
9M 4EN ! MARK
ME
LSN"T-NCEC
URVEYt
St UCEASOSURV[YOR
AE AC
SN&D>S ON
WOOD ENCE
CLRV
RN
C=FLOU CORNER
tMl"MASU2D
Pam,
PK 0N10 INTERSECTION
SNSO�St tvA'AND DISK
ASP iAEr 1 't
ICI CALCIAIFn
C NTERL NE
MONO IN1 fONCRETE
Nt
N{FOUNDION
MhS-NO REDCORNER
NCF=NOCR 2POitND
PK=ARK}12 SALON
ft
IR, SE7
SIR, 1,21P NRO 'B'83
CAN. NI. FENCE
cIF- OIAN.INK II NCk
HE=FO
FIP=FOUND IRON PIPE
O/A-OVERA!
LL
ONIOF BEGINNING
'OB-'PO.Ni OF ESEGINNiNG
TSM- TEMPOPUV2Y RENCN MARK
�9.i1fK ----IS ------
CM'= CORRJGAIFD METAL I'
FIR=FOUNDIRON On
OHW=OVERHEAD W-R-PB
POC POINT OF COMMENCTMENr
TpB-TOPOFSANK
COL=COLURAN
CONIC=CONCa-t
NPD-Y FOUND NAIL& DISK
OR.-OFFICIALREC012DS
POt POINTONUNE
TWP- TOWNSTHI
At UMINUM FENCE
C/S-CONCRETESLAS
FOP =FOUND OPEN PIPE
F P EO ND PINCHED FIRE
ILI -PLAT
P9=PI AT BOOK
PRC POLNr OF RFV RSE CURVE`
PRO PERMIDDRE! REFERENCE MONUMENT
U.E= UT11 PIP FASEMEM
=COVERED
_CO,- CLEAR SM-IT TRIANGLE PINCHED
-' U
VF=VINYLIENCE
,This
)OB #15se8s2OLD
SURVEYOR'S NOTES:...
1.) Current title Information on the subject property had not been
furnished to initial Point Lana` Surveying, LLC at the time of this
SITE PLAN
2.) This sketch was prepared without the benefit of a title search,
No instruments of record reflecting ownership, easements or
rights -of -way were furnished to the undersigned, unless otherwise
shown hereon.
S.) Roads, walks, and other similar items shown hereon were Lake
SURVEYOR'S CERTIFICATE and
certifies that f the hereon descnbed
�4� p,�
property ing. V rr"X p
meets th�f+1P c to 44{, P;actice for
survey s f rsldard of Land
n2C)
( rstr ry
pun ant f(o Section 4 ,� S [ft)@y
to � I
�' gate: A2 03.1 3
F t 708 Water Oak Dr
531- Drive
Tarpon Springs, Honda
Phone: Water
P
! 990
FlondaPtS7123@gmail coin
LB# 8183 a
c nl
>ate of S¢c Plan 12-30 2z
DWG AS -EH I B L2 C}1.9-SITE
=pe;
Drawn b DJB
y�
-hecked
by.JH
:EvlSl�ws
from engineering plans and are subject to survey.
This SITE PLAN does not reflect nor determine ownership.
CE-4.)
6F� 119t4'Q0'
`aj ow" }� i r �T
R h
5.) This SITE PLAN is subject to matters shown on the Plat of
�� Jt fL RDA
.
fir ,I i f SK,z> tTy
`ABBOTT SQUARE PHASE I B'
JeffM�-,, .-----._...-_
IT
6.) Dimensions shown hereon are in feet and decimal portions
reof.
eContractor
_1 For-
F A R JR AND
t
Q
7.) and owner are to verify all setbac IS, building
MAPPER NODE
dimensions, and layout shown hereon prior to any construction,
NOT VALID WITHOUT THE ORIGINAL
and immediately advise initial Point Land Surveying, LLC. of any SIGNATURE AND SEAL OF A FLORIDA +m'
deviation from information shown hereon. Failure to do so will be LICENSED SURVEYOR AND MAPPER Initial Point Land Surveying, LLC_
at user s sole risk
New Development Check List
Elevation: A Garage: 9
I
Roof Single Dimension/Architectural: 0) 1 f) (I AO
v Notice to Building Official of
Use of Private Provider
Effective January 20, 2003
Project Marne: 36508 Smithfield Lane
04-26-21-0150-00900-0020
Parcel Tax ID:
Services vices to be provided: Plans Review X Inspections
Note: If the notice applies to either private plan review or private inspection services the Building
Official may require, at his or her discretion, the private provider be used for both services pursuant to
Section 553.791(2) Florida Statute,
owner, affirm I have entered into a contract with the Private Provider indicated below to conduct the services
indicated above.
Private Provider Finn: VIRTUAL REVIEW ASSIST, INC.
Private Provider: DEBRA ANNE KLAHR
Address: 747 SW 2ND AVE- SUITE 170,301,357,& 358, GAINESVILLE, FL 32601
Telephone: 813-376-3088 Fax: N/A
Email Address (Optional): deb@virtualreviewassist.com
Florida License, Registration or Certificate #: (LIC # BU1967/ PX2300/ BN4615)
I have elected to use one or more private providers to provide building code plans review and/or inspection
services on the building that is the subject of the enclosed permit application, as authorized by s. 553.791, Florida
Statutes. I understand that the local building official may not review the plans submitted or perform the required
building inspections to determine compliance with the applicable codes, except to the extent specified in said law.
Instead, plans review and/or required building inspections will be performed by licensed or certified personnel
identified in the application. The law requires minimum insurance requirements for such personnel, but I
understand that I may require more insurance to protect my interests. By executing this form, I acknowledge that I
have made inquiry regarding the competence of the licensed or certified personnel and the level of their insurance
and am satisfied that my interests are adequately protected. I agree to indemnify, defend, and hold harmless the
local government, the local building official, and their building code enforcement personnel from any and all
claims arising from my use of these licensed or certified personnel to perform building code inspection services
with respect to the building that is the subject of the enclosed permit application.
.1 understand the Building Official retains authority to review plans, make required inspections, and enforce the
applicable codes within his or her charge pursuant to the standards established by s. 553.791, Florida Statutes. If I
make any changes to the listed private providers or the services to be provided by those private providers, I shall,
within I business day after any change, update this notice to reflect such changes. The building plans review and/or
inspection services provided by the private provider is limited to building code compliance and does not include
The following attar eats are provided as required:
1. Qualification statements and/or resumes of the pxivate provider and all duly authorized representatives
2,.Proof of insurance for professional.and comprehensive liability in,the.anaount.of 1 millionper
o c-currence relating to all servicd-s performed as a private provider,'hioluding tail coverage for a minimum.
of 5 years subsequentto the perfbrmance of building code inspection services.
(signature) .
Print
Name,
Address °
Telephone
No.
Pleaseuse appropriate notary block.
SPATE OF FLORIDA .
COUNTY OF I-iILLSBOROi: GH
LTMMM
Befuerne, this day Of
20— personally
'was exeGuted for the purposes ther5ml
Corporation
Beforem,,tlig 22ND day of
MAY . 20 2
personally appeared
Of
Lennar Homes LL
corporation, on
behalf oftho state corporation, who
exeouted the foregoing instrument and
aclokwlodged bief= one that same was
executed for the purposes therein
expressed.
Partnership .
Print Partnership Name
By:
(signature)
Print
Name-
Its:
Address+
Telephone
Noa
Before me, ibis day
of 20
personally appeared
p er/went on behalf• of
a partnership, Who eXeCUt(,dth0
foregoing instrument kud,
acknowledged btfoTe me that same
Personally known X or- Pro ducedidq#toation Type ofidontficatsonproduced
5ignatarq ofNotars, L PrintN e A FiL -CAL
NoiaryPualzo Stamp; ` ASHLEE CALLAHAN
*_ aMY COMMISSION N29 980
Commission Expires, ��p� ��°' EXPIRES: Nmnter30, 2026
Pacra. 9 rif').
VR/\
VIRTUAL REVIEW ASSIST
Private rov r
Plan Compliance Affidavit
Private Provider Firm: Virtual review Assist, Inc.
Private Provider: Debra Anne Klahr, BU1967
Address; 747 Southwest 2"d Avenue
Gainesville, Fl, 32601
Phone: 813-391- 959
Email. Inc ' ? rrttualreview ssist.com
Project, :New SFR
LANE
i a
•
appropriateand holds the
Name: Debra Anne Klahr
Plan Sheets CS,Al,A2,A3,A4,A4.l,A5,A6.l,A6, SN0,SN1, P.
Florida License/Registration/Certification #(s) and description
FS468 Certified Standard Plans Examiner
License #. PX2300
Signature of Reviewer.
SWORN AND SUBSCRJBED before one by Debra Anne Klahr
being personally known to and or having produced as identification
and who being fully sworn and cautioned, state that the
for going is true d correct to the best of his/her knowledge or belief.
1
igna ure of No
Prune Name
Notary Public: NOTARY STAMP BELOW My
commission expires:
Q COM11 ER IAL BUILDING SERVICES DIVISION RESIDENTIAL
BUILDING PERMIT DATA SHEET
0
BuildingyPlumbingRoof
On Site Piping
D Walk-in Cooler E] Refrigeration
MIMMM7Ofll
a
DATE: 3/25/2023
EXAMINER: b bra K6ahr PX230C
IV Electrical Amp
..®.EL:] Ins ection 00ntl .
El Medical Gas [I Fire Sprinklers
El Irrigation El Fire Alarm
El Irrigation Raeleftow Assembly El Demolition
E hood El Ansul
E Other [l Other
T e Construction: V# Risk Category: Occupancy Load
f ane�lassicaiBcan: Assembly �usincss ay CarelEducational
Factory °Hazardous Institutional ®ivTercantile
Residential R�3 ",-,,Storage [_j Utility
Building Use: ZN L FAMILY R IbEI�1 l Alteration Level I Level 2 ,,Level 3
® New Construction ® Interior Finish ❑ interior Remodel El Exterior Remodel [J Addition El Revision
Overall Size: Number of Stories: Total Sq. Ft.:
30 X 46 2 272
Living Area: 2217 Covered Area: 455
# of Bedrooms:
# of Baths: 2.
Cost per square foot: Estimated Value:
Roof e: ® Shin le Nile j� Built-up Metal Other Scares. 13
Zoning: Wi orne Debris: Energy Code:
Inside 'Outside 405-2022 UP
Flood Zone: X Base FIood Elevation: Finish Floor Elevation:
Hydrostatic Vents? Yes ' No Sq. Ft. Enclosed Space belowFE.
# of Vents: Size of Vents: Total Sq- In. Pe7;!in
nt Op:n s
Central A/ heat innip dow A/C
s L ®has heat E] Electric heat
Front Rear Left
2 As per Approved Site Plan
Comments:
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4
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